The Communist Party of China（CPC）Central Committee and the State Council issued a guideline on deepening reform in the healthcare security system，which gives a high functional positioning to the strategic purchase of the healthcare security fund but the existing literature has not yet made a comprehensive and systematic explanation about it. Domestic and foreign research shows that health insurance has changed from a simple third-party payer to a strategic purchaser，but the understanding of strategic purchasing is a historical and dynamic process that must consider the internal and external environment of the healthcare security system. The connotation of strategic purchasing with Chinese characteristics is different from that of foreign countries，and which should be combined with the actual situation of China’s health resource allocation and medical service utilization. Therefore，this paper makes a preliminary explanation of the connotation of strategic purchasing with Chinese characteristics from five purchase elements including “who will buy”，“for whom to buy”，“what to buy”，“how to buy” and “how to pay”. This paper argues that the National Healthcare Security Administration（NHSA）and its agencies，as strategic purchasers，should strive to improve the fair use of medical services of different income-level people and purchase “all medical expenses” for the insured people and promote the optimal allocation of medical resources through purchasing integrated healthcare system. At the same time，improving the strategic purchasing tools and reforming payment mechanisms to achieve the goal of healthy China.